Virtual reality (VR), an immersive technology simulating interactive three-dimensional environments, has been applied in adolescent alcohol and other drug (AOD) education. This systematic scoping review provides an in-depth understanding of its latest applications and evaluates the evidence base from nine studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol, this scoping review conducted a comprehensive search across five major databases to identify peer-reviewed studies on VR interventions targeting adolescent AOD behavior, published between January 2018 and January 2025. Articles were screened and evaluated through a multistage process. The review identified nine studies involving four different VR intervention projects from the United States, Australia, Denmark, Taiwan, and Germany. These studies primarily addressed e-cigarettes (3 studies) and alcohol consumption (6 studies) and show promise in influencing attitudes, knowledge, and refusal skills, particularly through immersive experiences that students find realistic and enjoyable. However, the evidence largely focuses on proxy measures rather than demonstrating changes in behavior. VR offers innovative potential for AOD education by increasing engagement and effectiveness. However, current research primarily focuses on user experience and satisfaction, with only limited evidence having emerged on behavioral outcomes.